The long-term objective of this project is to provide a smoking-cessation intervention tool for health care providers in prenatal settings. Smoking during pregnancy is a significant public health issue. The prevalence of smoking in women of child-bearing age generally ranges between 17 and 35 percent worldwide, and is heavily influenced by maternal age, ethnicity, education, and socioeconomic level. Smoking while pregnant has been linked to several serious health effects in infants, including impaired lung function, low birth-weight, and preterm birth. Clearly, interventions to prevent smoking during pregnancy have enormous public health importance, but existing interventions have achieved sub-optimal outcomes. This application proposes development of QuitAdvisorOB, an interactive, web-distributable, clinical decision support software application for computers or mobile devices. Based on proven patient-centered counseling techniques such as Motivational Interviewing, the 5 A's (ask, advise, assess, assist, and arrange), and Stages of Change, QuitAdvisorOB will assist prenatal care givers in providing patient-tailored smoking cessation counseling, while facilitating provider adherence to evidence- based practice guidelines. During Phase I, we will develop content and mock-ups of the proposed tool, create a web-based functioning prototype, and subject it to formal usability testing in OB/GYN physicians and nurses, and a pilot study evaluating the prototype's effect on the patients' progression along the stages-of-change continuum. PUBLIC HEALTH RELEVANCE: This research effort will impact public health by developing a health-care provider tool that aids in smoking-cessation counseling in pregnant women. Reducing smoking in pregnant women has significant health benefits for infants and children.